President Obama repeatedly assured Americans that after the Affordable Care Act became law, people who liked their health insurance would be able to keep it. But millions of Americans are getting or are about to get cancellation letters for their health insurance under Obamacare, say experts, and the Obama administration has known that for at least three years.

Four sources deeply involved in the Affordable Care Act tell NBC News that 50 to 75 percent of the 14 million consumers who buy their insurance individually can expect to receive a “cancellation” letter or the equivalent over the next year because their existing policies don’t meet the standards mandated by the new health care law. One expert predicts that number could reach as high as 80 percent. And all say that many of those forced to buy pricier new policies will experience “sticker shock.”

None of this should come as a shock to the Obama administration. The law states that policies in effect as of March 23, 2010 will be “grandfathered,” meaning consumers can keep those policies even though they don’t meet requirements of the new health care law. But the Department of Health and Human Services then wrote regulations that narrowed that provision, by saying that if any part of a policy was significantly changed since that date -- the deductible, co-pay, or benefits, for example -- the policy would not be grandfathered.

Buried in Obamacare regulations from July 2010 is an estimate that because of normal turnover in the individual insurance market, “40 to 67 percent” of customers will not be able to keep their policy. And because many policies will have been changed since the key date, “the percentage of individual market policies losing grandfather status in a given year exceeds the 40 to 67 percent range.”

That means the administration knew that more than 40 to 67 percent of those in the individual market would not be able to keep their plans, even if they liked them.

Yet President Obama, who had promised in 2009, “if you like your health plan, you will be able to keep your health plan,” was still saying in 2012, “If [you] already have health insurance, you will keep your health insurance.”

“This says that when they made the promise, they knew half the people in this market outright couldn’t keep what they had and then they wrote the rules so that others couldn’t make it either,” said Robert Laszewski, of Health Policy and Strategy Associates, a consultant who works for health industry firms. Laszewski estimates that 80 percent of those in the individual market will not be able to keep their current policies and will have to buy insurance that meets requirements of the new law, which generally requires a richer package of benefits than most policies today.

The White House does not dispute that many in the individual market will lose their current coverage, but argues they will be offered better coverage in its place, and that many will get tax subsidies that would offset any increased costs.

“One of the main goals of the law is to ensure that people have insurance they can rely on – that doesn’t discriminate or charge more based on pre-existing conditions. The consumers who are getting notices are in plans that do not provide all these protections – but in the vast majority of cases, those same insurers will automatically shift their enrollees to a plan that provides new consumer protections and, for nearly half of individual market enrollees, discounts through premium tax credits,” said White House spokesperson Jessica Santillo.

“Nothing in the Affordable Care Act forces people out of their health plans: The law allows plans that covered people at the time the law was enacted to continue to offer that same coverage to the same enrollees – nothing has changed and that coverage can continue into 2014,” she said.

Individual insurance plans with low premiums often lack basic benefits, such as prescription drug coverage, or carry high deductibles and out-of-pocket costs. The Affordable Care Act requires all companies to offer more benefits, such as mental health care, and also bars companies from denying coverage for preexisting conditions.

Today, White House spokesman Jay Carney was asked about the president’s promise that consumers would be able to keep their health care. “What the president said and what everybody said all along is that there are going to be changes brought about by the Affordable Care Act to create minimum standards of coverage, minimum services that every insurance plan has to provide,” Carney said. “So it's true that there are existing healthcare plans on the individual market that don't meet those minimum standards and therefore do not qualify for the Affordable Care Act.”

Other experts said that most consumers in the individual market will not be able to keep their policies. Nancy Thompson, senior vice president of CBIZ Benefits, which helps companies manage their employee benefits, says numbers in this market are hard to pin down, but that data from states and carriers suggests “anywhere from 50 to 75 percent” of individual policy holders will get cancellation letters. Kansas Insurance Commissioner Sandy Praeger, who chairs the health committee of the National Association of Insurance Commissioners, says that estimate is “probably about right.” She added that a few states are asking insurance companies to cancel and replace policies, rather than just amend them, to avoid confusion.

A spokesman for America's Health Plans says there are no precise numbers on how many will receive cancellations letters or get notices that their current policies don’t meet ACA standards. In both cases, consumers will not be able to keep their current coverage.
Those getting the cancellation letters are often shocked and unhappy.

George Schwab, 62, of North Carolina, said he was "perfectly happy" with his plan from Blue Cross Blue Shield, which also insured his wife for a $228 monthly premium. But this past September, he was surprised to receive a letter saying his policy was no longer available. The "comparable" plan the insurance company offered him carried a $1,208 monthly premium and a $5,500 deductible.

And the best option he’s found on the exchange so far offered a 415 percent jump in premium, to $948 a month.

"The deductible is less," he said, "But the plan doesn't meet my needs. Its unaffordable."

"I'm sitting here looking at this, thinking we ought to just pay the fine and just get insurance when we're sick," Schwab added. "Everybody's worried about whether the website works or not, but that's fixable. That's just the tip of the iceberg. This stuff isn't fixable."

Heather Goldwater, 38, of South Carolina, is raising a new baby while running her own PR firm. She said she received a letter last July from Cigna, her insurance company, that said the company would no longer offer her individual plan, and promised to send a letter by October offering a comparable option. So far, she hasn't received anything.

"I'm completely overwhelmed with a six-month-old and a business,” said Goldwater. “The last thing I can do is spend hours poring over a website that isn't working, trying to wrap my head around this entire health care overhaul."

Goldwater said she supports the new law and is grateful for provisions helping folks like her with pre-existing conditions, but she worries she won’t be able to afford the new insurance, which is expected to cost more because it has more benefits. "I'm jealous of people who have really good health insurance," she said. "It's people like me who are stuck in the middle who are going to get screwed."

Richard Helgren, a Lansing, Mich., retiree, said he was “irate” when he received a letter informing him that his wife Amy's $559 a month health plan was being changed because of the law. The plan the insurer offered raised his deductible from $0 to $2,500, and the company gave him 17 days to decide.

The higher costs spooked him and his wife, who have painstakingly planned for their retirement years. "Every dollar we didn't plan for erodes our standard of living," Helgren said.

Ulltimately, though Helgren opted not to shop through the ACA exchanges, he was able to apply for a good plan with a slightly lower premium through an insurance agent.

He said he never believed President Obama’s promise that people would be able to keep their current plans.

"I heard him only about a thousand times," he said. "I didn't believe him when he said it though because there was just no way that was going to happen. They wrote the regulations so strictly that none of the old polices can grandfather."

For months, Laszewski has warned that some consumers will face sticker shock. He recently got his own notice that he and his wife cannot keep their current policy, which he described as one of the best, so-called "Cadillac" plans offered for 2013. Now, he said, the best comparable plan he found for 2014 has a smaller doctor network, larger out-of-pocket costs, and a 66 percent premium increase.

“Mr. President, I like the coverage I have," Laszweski said. "It is the best health insurance policy you can buy."

We are 17 Trillion in debt, and the interest rate scam is about to get real interesting. 2008 was a once in a lifetime event, if this is the lone thing we got outta it, its prob not going to happen in my lifetime.

Just like keystone. If that goes through, alternative energy isnt going to happen in my lifetime either.

You hit on a part of how wealth is being eroded from main street. Elderly people how own their homes and want to do a slow reverse mortgage are basically charged a 50% to 100% mortgage insurance tax for every dollar they take out. The slower they take the money out, the more that goes to UNNECESSARY mortgage insurance. That is money that would otherwise be flowing back into the local economy.

It has been one month since the disastrous start of Healthcare.gov, the seriously impaired federal health insurance marketplace.

And what a month it’s been. For the first 16 days, a federal government shutdown largely deflected attention from the website’s problems. But since then, three congressional hearings have been held — and more are planned. Political pundits are anointing winners and losers (mostly losers) and trying to predict how the fallout could affect congressional elections next year.

I’m more interested in real-life winners and losers, people whose lives will be changed for better or worse because of the Affordable Care Act.

Clearly, if the website problems persist for much longer and people are unable to sign up for coverage, the list of losers will grow longer by the week. Consumers will lose because they won’t be able to enroll in health plans. Insurers will lose because they will have far fewer customers than anticipated. Hospitals will lose because the law cuts back their reimbursement for care they give to the uninsured. And on and on.

But for the moment, let’s assume some — or most — of those problems will be fixed by the Nov. 30 date promised by the Obama administration.

Winners

On a very obvious level, winners include young adults who can now remain on their parents health plans until age 26.

They include consumers with medical ailments who have been denied health insurance because of pre-existing conditions.

They include residents of states that opted to expand their Medicaid programs for the poor to cover those with incomes of up to 138 percent of the federal poverty level ($15,856 for an individual and $32,499 for a family of four).

Losers

By contrast, losers include those with lower incomes who live in states that decided not to expand their Medicaid programs. The Daily Briefing run by the consulting firm The Advisory Board Co. had a smart look this summer at which states will have the most uninsured residents in 2016. Being uninsured means you’re losing out.

Also sure losers are undocumented immigrants, who are ineligible for benefits or subsidies under the act.

And for now, at least, small businesses lose out because of the Obama administration’s ongoing delays launching a health insurance marketplace for small businesses. (Healthcare.gov, by contrast, is an insurance marketplace for individual consumers.)

Too Soon to Say

Another group that many commentators count as losers are the hundreds of thousands of consumers who have received cancellation notices from their individual health insurance companies because their policies don’t meet criteria set forth in the Affordable Care Act.

I hesitate to call all of them losers because some of them will be eligible for subsidies from the federal government to offset the cost of their new health insurance, and others will pay less in the new marketplace for better coverage. To be sure, some people clearly will lose out because they will pay more for their coverage — and their benefits won’t be all that much better to offset it.

What Others Say

The New Yorker’s Ryan Lizza had an interesting piece this week in which he spoke to economist Jon Gruber, who broke down winners and losers this way:

About eighty per cent of Americans are more or less left alone by the health-care act—largely people who have health insurance through their employers. About fourteen per cent of Americans are clear winners: they are currently uninsured and will have access to an affordable insurance policy under the A.C.A.

But much of the current controversy involves the six per cent of Americans who buy their own health care on the individual market, which the A.C.A. has dramatically reformed. Gruber argued that half of these people (three per cent of all Americans) will have little change to their polices. “They have to buy new plans, but they will be pretty similar to what they had before,” he said. “It will essentially be relabeling.”

The other half, however, also three per cent of the population, will have to buy a new product that complies with the A.C.A.’s more stringent requirements for individual plans. A significant portion of these roughly nine million Americans will be forced to buy a new insurance policy with higher premiums than they currently pay.

Economist Justin Wolfers tweeted the previous few paragraphs as a chart:

I posed this question to several smart folks I know — journalists, scholars, think-tank folks — and this what they said.

Boston University health economist Austin Frakt, who blogs at The Incidental Economist (a must-read), said he breaks down winners and losers into short-term, mid-term and long term.

“Short term there are no winners,” Frakt wrote, mostly because of the problems with the rollout. Even if the website issues are fixed by the end of this month, as promised, it will still be hard to get consumers signed up by Dec. 15 for coverage that begins on the first of the new year.

Looking ahead, Frakt wrote:

Medium term (next year, more or less): Providers and would-be Medicaid beneficiaries in non-expansion states are losers. Winners are those who finally get coverage (let’s assume the exchanges function by or soon after the new year). Entities that had to scramble and make sub-optimal decisions due to late-functioning exchanges lose. Same for people who were impatient and jumped at bad deals.
Still, this will be an uncertain, transition period. There may be insurers that opt not to re-enter the market next year. There may be exchanges that look unstable. I would expect some will be near failure, if not fail. All the obvious entities in those states will be losers, unless something can be done.

Big winners are researchers and those who might consume their work. We will learn a lot about exchanges. This is good for the future of health policy.

Long term (well beyond next year): I expect more states to expand Medicaid, bringing the obvious winners. I expect most exchanges to function, and that’s a big win for residents of those states. I expect Congress to continue to not be able to sensibly deal with failing exchanges and other glitches in the law, so there will be losers.
On the whole, I think the law will prove to be successful, and I consider that a win for America. If only we could make sensible mid-course corrections we’d all be winners.

Cost control will remain an issue. If we don’t make progress there, we’ll all be losers in the very long term. But we may have a decade before that really binds.

Dr. Scott Gottlieb, a resident fellow at the American Enterprise Institute and former FDA official, suggested many of the same winners and losers as I identified above.

Other winners include older, sicker patients who do not have employer-provided health insurance, as well as lower-income younger families who earn between $40,000 and $60,000 a year, because they will qualify for subsidies that will lower their costs.
Among the losers: Those who are young and healthy, who will pay more for coverage than they did before. Families who earn more than $60,000 face high premiums even with subsidies. “Also upper income healthy people lose big. They’re forced to buy a pricier policy than they probably want or need with no benefit of subsidies.”

The biggest losers (I agree) are those who earn less than the federal poverty level and who live in states that did not expand their Medicaid programs. When the Affordable Care Act passed in 2010, Congress envisioned that every state would expand Medicaid and it did not set aside money to provide premium subsidies for those patients in the health insurance exchanges. So they will neither receive Medicaid nor help paying their premiums.

Ironically, in the same states, federal subsidies are available for those who earn more than the poverty level. “Instead of getting Medicaid, they now get Obamacare with full subsidy. If they are young, a bronze plan could be very cheap,” Gottlieb wrote. Although their out-of-pocket costs will be higher than under Medicaid, “they’ll get a better policy with a real network that while skinny, will surely beat Medicaid.”

Dan Diamond, managing editor of the Advisory Board’s Daily Briefing, told me he thought it was too early to pick winners and losers based on the current website problems. But if they hold he said:

Insurers MAY lose — they may get fewer new customers in year one than expected, despite making investments in IT systems, acceding to market reforms, and other perceived sacrifices.

Hospitals and doctors MAY lose, if more folks stay uninsured and they have to carry more bad debt.

Hell when I was still working - prior to and up to 2008 - insurance companies were canceling policies and doubling rates causing many companies to discontinue group health programs.

What the insurance industry is doing now is no different than before - EXCEPT - Now they can blame the government for what they have been doing for years prior to ever the 1st mention of a universal health care program or any other type of national program. And now they are really putting the screws to the public to accelerate continuing exorbitant increases in the cost of insurance - while making the coverage worse.

Since ACA was announced as a direction that the government ( HUH - Funny That - Actually reflected the wishes of many of the people for once ) wanted to go in getting the population covered for medical care and treatment - most especially those who are too poor to be able to afford any kind of health plan - the insurance companies have pulled out all stops and are deniying coverage like never before and are trying to blame ACA - when it is in fact all artificial increases and denials of coverage to lever public angst towards ACA. At the same time positioning themselves for a stronger rape of the public for coverage - whether or not they can get the ACA repealed.

Their program ( insurance companies ) should be called out for being what it is = illegal rate hikes for diminishing coverage. All in the service of greed of the for profit system.

Edit =

The insurance industry has been out of control and getting worse for forever. We all knew something had to be done to get costs back to reality. Now perhaps the private insurers will price themselves out of business - as who the hell would take a policy with a $5000 deductible ? Perhaps someone who's medication cost $4000 dollars a month and the will receive benefit from the policy as in the 2nd month the policy will be paid for the year on the deductible. But they may still not want that policy depending on percentage of prescription drug coverage.

SO - Private Ins may well swell the ranks of those choosing government ins.

What do you think the response from private insurers will be when they start losing customers? Droves of customers. The insurance companies gravy train for decades.

In many cases, the key word left out is, UNDERINSURED. People who were deemed UNDERINSURED may face an increase in their premium.

It's important to be clear on what the issue really is, policies are being canceled if a person only has hospitalization coverage but no doctor's visits.

While I don't like the idea of canceling someone for having hospitalization only, it does make sense because if someone goes to a hospital, who does the hospital consult with regarding the patients past health history if that patient has not been seeing a doctor prior to coming to the hospital?

" That means the administration knew that more than 40 to 67 percent of those in the individual market would not be able to keep their plans, even if they liked them.

This all sounds very ominous until you consider that the naturally high turnover rate associated with the individual market means that it’s highly unlikely that individuals would still be enrolled in plans from 2010 in 2014. In fact, the Obama administration publicly admitted this when it issued the regulations in 2010, leading Republicans like Sen. Mike Enzi (R-WY) to seize on the story in order to push for repeal of the grandfather regulations. Here is a story in The Hill from Sep. 22, 2010 pointing to this very same 40 to 67 percent range: "

Let's see. This was "common knowledge" in 2010, yet 0bama was still using the "if you like your current plan" untruth in 2012. Please explain how that was not a deliberate deception that the WH knew about since 2010? They may have publicly admitted the turnover rate somewhere (I never caught that) but I sure heard 0bama;s state of the union and all the other VERY PUBLIC SPEECHES where he sought to deceive.

What a politican. talks out of both sides of his mouth, admits it, and you defend him for "not lying".

This thread is about how the 0bama knew millions would not be able to keep their existing insurance and hence LIED to the public. You have not refuted that claim, you have DEFENDED the dishonesty. Can you not ever stay on topic when you are in the wrong? The rightwing has nothing at all to do with 0bama's lies.

Boy you really are dumb. Even the site you linked, something called Think progress says that people are going to lose their existing policies to subsidize all of those who don't work. Do you even read your own articles? Can you read? This is the problem, you must not be competent.

Insurance companies wrote this, it was to give them more power, plain and simple. The trade off was an extremely weak preexisting conditions clause. or which they left plenty of room to get around. "Denying" and "giving a high as fuck estimate" I guess are two different things.

The great corporate success of the 1980's and 1990's was deregulating the banks and finance.

2000's was to get the nation used to perpetual war- -which they are now fine with. Literally bombing villiages overseas and no one gives a damn.

2010's will be forcing the people into customers for those very corporations, literally fining them if they dont buy their products. SS is coming next. Goldman is licking its lips.

By the year 2020 the population will be so dumbed down from electing corporatism shitheads that no one is going know what is going on anyways.

You're right. I wish McCain won. Then we wouldn't even have a country to complain about because he's a completely insane relic of a bygone era that doesn't even know what fucking year it is. Yes, we need more like that. But here is the inescapable: I was doing research for a paper and found that Bush was taking in more revenue than he was spending But then I found at first that wasn't the case and Clinton's spending was more and Obama's spending was more. Question: How can start 2 wars and increase the size of federal government over 30% with the TSA and Dept. Homeland Security and spend less money? There is only one answer unless you're a complete, fucked up, incompetent, stupid, useless motherfucker who needs his or her high school diploma reassessed. You know what it is? Huh??? Huhh???????? He borrowed and borrowed and borrowed AND WORSE: HE DIDN"T PAY! Was it planned? Who gives a fuck. That's what he did.